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HomeMy WebLinkAboutThyssenkrupp Elevator AI'F'LI(:AI ION AND l:tKI II'II:AI ION I-VK nAYIVICIN I AIA DUUUMCIV1 cT/UL/UYna PAGE ONE OF THREE PAGES TO: R131 CONSTRUCTION,LLC PROJECT: VILLAGE ON THE GREEN APPLICATION NO: 3 Distribution to: - 005EAK401-03 OWNER CUST.NO. 9319557 RE-SENT: ARCHITECT _ PERIOD TO: 7/31/10 CONTRACTOR FROM CONTRACTOR: VIA CONSTRUCTION MANAGER: THYSSENKRUPP ELEVATOR , i_� r 2726 E.KEMPER ROAD VIA ARCHITECT: PROJECT NOS: / ' CINCINNATI,OH 45241 JUL. .� �p��Y, CONTRACT FOR: ELEVATORS CONTRACT DATE: 11/18/09 CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's Aivledge, Pit Application is made for payment,as shown below,in connection with the Contract. information and belief the Work covered by this Application for Payment has been ""°° - _ - ___ Continuation Sheet,AIA Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein in,ow due. 1. ORIGINAL CONTRACT SUM 348,900.00 CONTRACTOR: THYSSENKRUPP ELEVATOR 2. Net change by Change Orders $ 0.00g� ,!_. 3. CONTRACT SUM TO DATE(Line 1 f 2) $ 348,900.00 B y: Qy A Xk DL. SZa� Pale.......Cl�� July 16,2010 4. TOTAL COMPLETED&STORED TO $ 239,400.00 ROSETTA BARNES/CONSTRUCTION COOL I�V:AT���t/1'-"" DATE (Column G on G703) State of:OHIO County of:HAMII1'TO `,.••. ) 5. RETAINAGE: Subscribed a sworn to before me this 16-Jul-1 *i a. 5 %of Completed Work $ 11,970.00 Notary Public. yK� ` ' � P'�M��A STEVENS S�;�0.>, �;,. ��'?'�° Notary Public, (Column D+E on G703) My Commission expires: tii,� ;*;S My Co State Af Ohi,b. 5 %of Stored Material $ 0.00 � 4 ; mmission Ex�ir� (Column F on G703) CERTIFICATE FOR PAYMENT FpF©Y° �'��' ' °t Total Retainage(Lines 5a+5b or In accordance with the Contract Documents,based on on-site o servations and the data Total in Column I of G703) $ 11,970.00 comprising this application,the Construction Manager and Architect certifies to the Owner 6. TOTAL EARNED LESS RETAINAGE $ 227,430.00 that to the best of their knowledge,information and belief the Work has progressed as (Line 4 Less Line 5 Total) indicated,the quality of the Work is in accordance with the Contract Documents,and 7. LESS PREVIOUS CERTIFICATES FOR the Contractor is entitled to payment of the AMOUNT CERTIFIED. PAYMENT(Line 6 from prior Certificate) 149,228.00 8. CURRENT PAYMENT DUE $ 78,202.00 AMOUNT CERTIFIED $ ---2g202-- 9. BALANCE TO FINISH,INCLUDING RETAINAGE $ 121,470.00 (Line 3 less Line 6) (Attach explanation if amount certified differs from the amount applied.Initial all figures on this Application and onthe Continuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved CONSTRUCTION MANAGER in previous months by Owner $0.00 $0.00 By: �Y A Date: / /)A6 Total approved this Month $0.00 $0.00 ARCHITECT: TOTALS $0.00 $0.00 By: Date: NET CHANGES by Change Order $0.00 This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein.Issuance,payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. AIA DOCUMENT G702/CMa APPLICATION AND CERTIFICATION FOR PAYMENT•1992 EDITION AIA ©1992 THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,DC 20006-5292 P A I D SEP 1 7 101r'9t2 7f2`/Pos/-6/ I CONTINUATION SHEET THYSSENKRUPP JOB# 005EAK401-02 PAGE PAGE 2 OF 3 APPLICATION AND CERTIFICATE FOR PAYMENT,containing PERIOD TO: 7/31/10 APPLICATION NO: 3 _ Contractor's signed Certification is attached. In tabulations below,amounts are stated to the nearest dollar. JOB NAME: VILLAGE ON THE GREEN DATE OF APPLICATION: 07/16/10 - A B C D E F G H I WORK TOTAL BALANCE ACTUAL COMPLETED COMPLETED& TO FINISH STORED ITEM SCHEDULED PREVIOUS THIS STORED % LESS RETAINAGE MATERIAL NO. DESCRIPTION OF WORK VALUE APPLICATION PERIOD TO DATE COMPLETED (C-F) TO DATE - 1 ENG/PREPRODUCTION 90,300 90,300 0 90,300 100% 0 2 JACK HOLE L 23,323 23,323 0 23,323 100% 0 3 OILDRAULIC JACK M 10,618 0 10,618 10,618 100% 0 10,618 L 6,362 0 0 0 0% 6,362 4 CAR SLING&PLATFORM M 6,194 0 6,194 6,194 100% 0 6,194 L 4,894 0 0 0 0% 4,894 5 HOISTWAY ACCESSORIES M 9,733 0 9,733 9,733 100% 0 9,733 L 7,830 0 0 0 0% 7,830 6 POWER UNIT M 19,466 0 19,466 19,466 100% 0 19,466 L 7,340 0 0 0 0% 7,340 7 CONTROLLER M 23,005 0 23,005 23,005 100% 0 23,005 L 7,340 0 0 0 0% 7,340 8 ENTRANCES M 11,502 0 11,502 11,502 100% 0 11,502 L 6,851 0 0 0 0% 6,851 9 CAB M 7,963 0 0 0 0% 7,963 0 L 6,362 0 0 0 0% 6,362 10 DOOR OPERATOR M 1,800 0 1,800 1,800 100% 0 1,800 L 1,957 0 0 0 0% 1,957 11 ADJUSTING L 5,160 0 0 0 0% 5,160 0 ■ TOTAL 258,0001 113,623 82,318 195,941 76% 62,059 82,318 CONTINUATION SHEET THYSSENKRUPP JOB# 005EAK403 PAGE PAGE 3 OF 3 APPLICATION AND CERTIFICATE FOR PAYMENT,containing PERIOD TO: 7/31/10 APPLICATION NO: 3 _ Contractor's signed Certification is attached. In tabulations below,amounts are stated to the nearest dollar. JOB NAME: VILLAGE ON THE GREEN DATE OF APPLICATION: 07/16/10 - A B C D E F G H I WORK TOTAL BALANCE ACTUAL COMPLETED COMPLETED& TO FINISH STORED ITEM SCHEDULED PREVIOUS THIS STORED % LESS RETAINAGE MATERIAL NO. DESCRIPTION OF WORK VALUE APPLICATION PERIOD TO DATE COMPLETED (C-F) TO DATE 1 ENG/PREPRODUCTION 31,815 31,815 0 31,815 100% 0 2 JACK HOLE L 11,644 11,644 0 11,644 100% 0 3 OILDRAULIC JACK M 2,749 0 0 0 0% 2,749 0 L 2,719 0 0 0 0% 2,719 4 CAR SLING&PLATFORM M 1,603 0 0 0 0% 1,603 0 L 2,092 0 0 0 0% 2,092 " 5 HOISTWAY ACCESSORIES M 2,520 0 0 0 0% 2,520 0 L 3,347 0 0 0 0% 3,347 6 POWER UNIT M 5,039 0 0 0 0% 5,039 0 L 3,138 0 0 0 0% 3,138 7 CONTROLLER M 5,955 0 0 0 0% 5,955 0 L 3,138 0 0 0 0% 3,138 8 ENTRANCES M 2,978 0 0 0 0% 2,978 0 L 2,929 0 0 0 0% 2,929 9 CAB M 2,061 0 0 0 0% 2,061 0 L 2,718 0 0 0 0% 2,718 10 DOOR OPERATOR M 1,800 0 0 0 0% 1,800 0 L 837 0 0 0 0% 837 11 ADJUSTING L 1,818 0 0 0 0% 1,818 0 TOTAL 90,900 43,459 0 43,459 48% 47,441 0 ■ I ' APPLICATION FOR PAYMENT f FE Y7 f PARTIAL WAIVER OF LIEN JUL 21 2010 Contractor: ThYSSenKtupp Elevator --- Address: 2726 E. Kemper Road �` _ - Cincinnati,Ohio 45241 Project Name and Address: V t LLAGQ_ b � • 3 AO A+j�. Ali% Ct° y C�11 VL DQ. • C Mcn e_L Period to:1-31 -1 D Job#: ODS E QIF - b - D3 The Undersigned has been contracted by REI Construction, LLC as a Contractor in connection with construction of the Project owned by Owner and located as indicated above. The Undersigned, for and in consideration of any and all amounts paid to the Undersigned up to and including the date of execution hereof and other good and valuable consideration, the receipt whereof is hereby acknowledged, waives and releases any and all liens, notices of liens or of character, against, on or relating to or connected with the above-described Project and improvements located thereon and related thereto, on account of labor or services, materials, equipment, tools, machinery or apparatus furnished or leased, or which may be furnished or leased by, or at the request of, the Undersigned for the Project. The Undersigned hereby warrants that the Project cannot be made subject to any valid lien or claim by anyone who furnished or leased labor or services, materials, equipment, tools, machinery or apparatus to, or at the request of, the Undersigned for use in the Project. This instrument, and the waiver, release and representations hereunder, are for the benefit of, and may be relied upon by, the Owner, its successors, assigns and mortgagees, the above-named General Contractor or Construction Manager, and any other person by or through whom payments have been made to the Undersigned. The undersigned, for and in consideration of the total payments in the sum of $ 4 1 , n the receipt of which is hereby acknowledged, does hereby waive, release remise and relinquish any and all right to claim any lien or liens for work done or materials furnished, or any kind or class of lien whatsoever for said building or premises or project Dated this 'RD I N day of 1 \N1-1 a,bib THYSSENKRUPP ELEVATOR CORPORATION Co any Name Rosetta Barnes BY: TITLE: Construction Coordinator Hosetfa Barnes NAME: Construction Coordinator STATE OF H COUNTY OF Subscribed and sworn to before me, a Notary Public in and for said County an tat t.fits 1 �D day of .\ U L� ,201 p My commission expires My county residence ig PAMELA STEVENS Notary Public o M State of hi e l; Y Commission Expire,, � Octob®r 3,201 Notary Printed �©F"6 THYSSENKRUPP ELEVATOR 0929850 REMIT TO: TIIYSSENKRUPP ELEVATOR CORPORATION �' � 2726 E.KEMPER ROAD CINCINNATI,OH 45241 Attention: CASH APPLICATIONS I_ /II! 4,,c://, SOLD REI CONSTRUCTION LLC CUSTOMER NO: 9319557 / eQ TO: 11711 N PENNSYLVANIA ,� CARMEL IN 46032-0000 INVOICE DATE: 07/16/2010 nnL INVOICE NO: 0929850 JOB NUMBER: 005EAK401 CODES: 18 029 084 00 01 CONTRACT#: RELbII'I'VH" FAY MEN-I FOR'I HIS RE: VILLAGE ON THE GREEN SUB-CONT#: INVOICE IS REQUIRED PRIOR TO CARMEL, IN CUST PO#: MOBILIZATION OF LABOR. HAMILTON COUNTY CONTRACTOR JOB#: TO: INVOICE FOR ELEVATOR WORK-MATERIAL SHIPPING 8-6-10 BEFORE NEXT BILLING CYCLE CONTRACT PRICE 348,900.00 348,900.00 VALUE OF MATERIAL AND/OR LABOR FURNISHED TO DATE 239,400.00 239,400.00 LESS RETAINAGE 11,970.00 227,430.00 LESS PREVIOUS BILLINGS 149,228.00 NET AMOUNT DUE AND PAYABLE 78,202.00 IF REMITTING DIFFERENT AMOUNT PLEASE GIVE AMOUNT AND REASON, THANK YOU: $ PLEASE CALL: (866) 719-5080 INVOICE: ROSETTA BARNES EXT: 4961 FAX NUMBER: (866) 545-4278 WAIVERS: MIKE TRENT EXT: 4999 INVOICES ARE DUE WHEN RENDERED CREDIT MGR: MIKE TRENT EXT: 4999 Goods or Services covered by this invoice were produced in compliance with the requirements of the Fair Labor Standards Act of 1938, as amended. �yy n !t fir. CBBO48-01 CUSTOMER INVOICE ' FDL076